AIC 300-CLAIMS EXAM 2025
QUESTIONS WITH ANSWERS
Insurers usually send denial letters
Select one:
B. By certified mail with a return receipt requested.
Some will also send a copy via regular mail in case the certified letter is not
accepted.
As methods of communication evolve, it's important for claims professionals to
remember that any written claims communication may be
Select one:
D. Subpoenaed.
Any written claims communication may be subpoenaed.
In which one of the following scenarios is a public adjuster most likely to become
involved?
Select one:
D. An insured's negotiations with the insurer on a complex claim are not going
well.
If a claim is complex, or if settlement negotiations are not progressing with the
insurer, the insured may hire a public adjuster to protect his or her interests.
Which one of the following statements regarding third-party administrators
(TPAs) is most accurate?
Select one:
B. TPAs handle claims, keep claims records, and perform statistical analyses.
Hugo is conducting an audit of a branch office claims operation. He is evaluating
timeliness of reports, number of files opened, proper releases taken, and
accuracy of data entry. Which one of Hugo's metrics is a qualitative audit factor?
Select one:
A. Proper releases taken
Proper releases taken is a qualitative audit factor; the others are quantitative.
D. Line underwriter.
Aaron works for a multi-line insurer. He works with insurance producers and applicants
to evaluate new business submissions and conduct renewal underwriting. Aaron is a
Select one:
,A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter.
Line underwriter. This describes the duties of a line underwriter, rather than a
staff underwriter. There is not enough information to determine which line of
business is being written. A public underwriter does not exist. Line underwriters
evaluate new submissions and perform renewal underwriting, usually by working
directly with insurance producers and applicants. Staff underwriters, meanwhile,
manage risk selection by working with line underwriters and coordinating
decisions about products, pricing and guidelines.
The first key to communicating empathetically as a claims professional is
Select one:
A. A comprehensive understanding of relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documentation relating to the claim.
D. Listening.
D. Listening.
Claims professionals should first listen carefully to understand what the claimant
is saying.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims
department for an insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and settle claims.
D. Total incurred amount of claims.
C. Cost to investigate, defend, and settle claims.
Cost to investigate, defend, and settle claims. LAE is the expense that an insurer
incurs to investigate, defend, and settle claims according to the terms specified
in the insurance policy.
.
In her role with an insurer, Katarina has opportunity to collaborate with not only
employees from her company, but also external experts with particular expertise. For
example, as part of her investigation, she hired an engineer to conduct a review of a
machine that was involved in a personal injury. Katarina is a(n)
Select one:
A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representative.
D. Claim representative.
Claim reps collaborate with more than other insurer employees. Many insurers
,employ a panel of experts that the claims rep can select according to the
investigation's needs
When Mehmet interviews witnesses as part of his claims investigation, he asks different
types of questions based on need, such as open-ended, direct, indirect, and leading.
Which type of question should Mehmet ask when he wants to set the interviewee at
ease and he is looking for explanation or elaboration of details in the interviewee's own
words?
Select one:
A. Open-ended
B. Direct
C. Indirect
D. Leading
A. Open-ended
Open-ended questions can be used to clarify an interviewee's statements.
Charlotte is handling a new claim and she has set the initial reserves at $1,000,000.
She has been asked to complete an internal report summarizing all the file status
information for distribution to management and updated as more information is
received. The report Charlotte is completing is most likely a
Select one:
A. Status report.
B. Summarized report.
C. Preliminary report.
D. Large loss report.
D. Large loss report.
Most insurers have guidelines outlining when and under what circumstances
large loss reports should be prepared.
In which one of the following scenarios is the right of subrogation most likely to be
employed by the insurer?
Select one:
A. An insured files a homeowners claim for stolen jewelry. An investigation reveals that
the jewelry is still in the insured's possession.
B. An investigation reveals that an insured set her own business on fire.
C. An insured files a claim for collision damage from a hit and run accident, when in fact
he backed into a utility pole.
D. A claims rep discovers that their insured's car accident was caused by a road
contractor who left equipment lying in the travel lanes of a highway.
D. A claims rep discovers that their insured's car accident was caused by a road
contractor who left equipment lying in the travel lanes of a highway.
The right of subrogation allows an insurer to recover payment from a negligent
third party.
In claims investigation, all bodily injury claims require
Select one:
, A. Statements from all witnesses.
B. Multiple claims payments
C. An attorney.
D. A medical investigation.
D. A medical investigation.
All bodily injury claims, including workers compensation claims, require a
medical investigation.
Before making initial contact with an insured or claimant, a claims representative should
Select one:
A. Research similar losses in the same geographical area.
B. Contact company counsel for a reservation of rights letter.
C. Prepare an approximate estimate based on similar losses.
D. Prepare a list of questions for the insured.
D. Prepare a list of questions for the insured.
Before making initial contact with an insured or claimant, a claims representative
should prepare a list of questions for the insured, along with information on how
the claim will be handled.
Carolina is a claim representative handling a liability claim. She is speaking to the
claimant over the phone and has informed him that his statements must be true under
penalty of perjury. When completed, she sent a transcription of the conversation to the
claimant for him to sign before a notary. Carolina has taken a(n)
Select one:
A. Affidavit.
B. Deposition.
C. Recorded statement.
D. Examination under oath.
C. Recorded statement.
A recorded statement is taken by the claims rep over the phone or in person.
.
One of Juan's responsibilities as a claims representative is to prepare internal reports,
such as preliminary, interim, large loss, and captioned. Which one of the reports Juan
prepares is required for claims with reserves that exceed a specified threshold?
Select one:
A. Interim
B. Large loss
C. Preliminary
D. Captioned
B. Large loss
Large loss reports are required by most insurers to summarize claims with
reserves above a certain threshold
In the process of assigning a claim, an internal claims handler will often transfer
information to the insurer's standard form, called the
Select one:
QUESTIONS WITH ANSWERS
Insurers usually send denial letters
Select one:
B. By certified mail with a return receipt requested.
Some will also send a copy via regular mail in case the certified letter is not
accepted.
As methods of communication evolve, it's important for claims professionals to
remember that any written claims communication may be
Select one:
D. Subpoenaed.
Any written claims communication may be subpoenaed.
In which one of the following scenarios is a public adjuster most likely to become
involved?
Select one:
D. An insured's negotiations with the insurer on a complex claim are not going
well.
If a claim is complex, or if settlement negotiations are not progressing with the
insurer, the insured may hire a public adjuster to protect his or her interests.
Which one of the following statements regarding third-party administrators
(TPAs) is most accurate?
Select one:
B. TPAs handle claims, keep claims records, and perform statistical analyses.
Hugo is conducting an audit of a branch office claims operation. He is evaluating
timeliness of reports, number of files opened, proper releases taken, and
accuracy of data entry. Which one of Hugo's metrics is a qualitative audit factor?
Select one:
A. Proper releases taken
Proper releases taken is a qualitative audit factor; the others are quantitative.
D. Line underwriter.
Aaron works for a multi-line insurer. He works with insurance producers and applicants
to evaluate new business submissions and conduct renewal underwriting. Aaron is a
Select one:
,A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter.
Line underwriter. This describes the duties of a line underwriter, rather than a
staff underwriter. There is not enough information to determine which line of
business is being written. A public underwriter does not exist. Line underwriters
evaluate new submissions and perform renewal underwriting, usually by working
directly with insurance producers and applicants. Staff underwriters, meanwhile,
manage risk selection by working with line underwriters and coordinating
decisions about products, pricing and guidelines.
The first key to communicating empathetically as a claims professional is
Select one:
A. A comprehensive understanding of relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documentation relating to the claim.
D. Listening.
D. Listening.
Claims professionals should first listen carefully to understand what the claimant
is saying.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims
department for an insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and settle claims.
D. Total incurred amount of claims.
C. Cost to investigate, defend, and settle claims.
Cost to investigate, defend, and settle claims. LAE is the expense that an insurer
incurs to investigate, defend, and settle claims according to the terms specified
in the insurance policy.
.
In her role with an insurer, Katarina has opportunity to collaborate with not only
employees from her company, but also external experts with particular expertise. For
example, as part of her investigation, she hired an engineer to conduct a review of a
machine that was involved in a personal injury. Katarina is a(n)
Select one:
A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representative.
D. Claim representative.
Claim reps collaborate with more than other insurer employees. Many insurers
,employ a panel of experts that the claims rep can select according to the
investigation's needs
When Mehmet interviews witnesses as part of his claims investigation, he asks different
types of questions based on need, such as open-ended, direct, indirect, and leading.
Which type of question should Mehmet ask when he wants to set the interviewee at
ease and he is looking for explanation or elaboration of details in the interviewee's own
words?
Select one:
A. Open-ended
B. Direct
C. Indirect
D. Leading
A. Open-ended
Open-ended questions can be used to clarify an interviewee's statements.
Charlotte is handling a new claim and she has set the initial reserves at $1,000,000.
She has been asked to complete an internal report summarizing all the file status
information for distribution to management and updated as more information is
received. The report Charlotte is completing is most likely a
Select one:
A. Status report.
B. Summarized report.
C. Preliminary report.
D. Large loss report.
D. Large loss report.
Most insurers have guidelines outlining when and under what circumstances
large loss reports should be prepared.
In which one of the following scenarios is the right of subrogation most likely to be
employed by the insurer?
Select one:
A. An insured files a homeowners claim for stolen jewelry. An investigation reveals that
the jewelry is still in the insured's possession.
B. An investigation reveals that an insured set her own business on fire.
C. An insured files a claim for collision damage from a hit and run accident, when in fact
he backed into a utility pole.
D. A claims rep discovers that their insured's car accident was caused by a road
contractor who left equipment lying in the travel lanes of a highway.
D. A claims rep discovers that their insured's car accident was caused by a road
contractor who left equipment lying in the travel lanes of a highway.
The right of subrogation allows an insurer to recover payment from a negligent
third party.
In claims investigation, all bodily injury claims require
Select one:
, A. Statements from all witnesses.
B. Multiple claims payments
C. An attorney.
D. A medical investigation.
D. A medical investigation.
All bodily injury claims, including workers compensation claims, require a
medical investigation.
Before making initial contact with an insured or claimant, a claims representative should
Select one:
A. Research similar losses in the same geographical area.
B. Contact company counsel for a reservation of rights letter.
C. Prepare an approximate estimate based on similar losses.
D. Prepare a list of questions for the insured.
D. Prepare a list of questions for the insured.
Before making initial contact with an insured or claimant, a claims representative
should prepare a list of questions for the insured, along with information on how
the claim will be handled.
Carolina is a claim representative handling a liability claim. She is speaking to the
claimant over the phone and has informed him that his statements must be true under
penalty of perjury. When completed, she sent a transcription of the conversation to the
claimant for him to sign before a notary. Carolina has taken a(n)
Select one:
A. Affidavit.
B. Deposition.
C. Recorded statement.
D. Examination under oath.
C. Recorded statement.
A recorded statement is taken by the claims rep over the phone or in person.
.
One of Juan's responsibilities as a claims representative is to prepare internal reports,
such as preliminary, interim, large loss, and captioned. Which one of the reports Juan
prepares is required for claims with reserves that exceed a specified threshold?
Select one:
A. Interim
B. Large loss
C. Preliminary
D. Captioned
B. Large loss
Large loss reports are required by most insurers to summarize claims with
reserves above a certain threshold
In the process of assigning a claim, an internal claims handler will often transfer
information to the insurer's standard form, called the
Select one:
